HESI RN
HESI Community Health Questions
Question 1 of 5
A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is at least likely to exacerbate asthma?
Correct Answer: C
Rationale: In this scenario, the correct answer is option C) Metoprolol tartrate (Lopressor). Metoprolol is a selective beta-1 adrenergic receptor blocker, which is less likely to exacerbate asthma compared to non-selective beta blockers like propranolol (option D). Asthma is a condition characterized by bronchoconstriction, and non-selective beta blockers can potentially worsen this by blocking beta-2 receptors in the lungs, leading to bronchoconstriction. Therefore, choosing a selective beta blocker like metoprolol reduces the risk of bronchoconstriction in asthma patients. Options A and B, Pindolol (Visken) and Carteolol (Ocupress), are also non-selective beta blockers and can exacerbate asthma symptoms. It is essential for nurses to understand the pharmacological properties of medications to provide safe and effective care to clients with comorbid conditions like asthma and high blood pressure. Educationally, this question highlights the importance of selecting medications based on their specific pharmacological properties and understanding how different medications can impact various conditions a client may have. Nurses need to be well-versed in pharmacology to make informed decisions when caring for clients with multiple health issues.
Question 2 of 5
A client is receiving atenolol (Tenormin) 25 mg PO after a myocardial infarction. The nurse determines the client's apical pulse is 65 beats per minute. What action should the nurse implement next?
Correct Answer: C
Rationale: In this scenario, the correct action for the nurse to take is to administer the medication (Option C). Atenolol is a beta-blocker commonly used after a myocardial infarction to reduce the workload on the heart by decreasing heart rate and blood pressure. A pulse rate of 65 beats per minute falls within the normal range for an adult, especially for a client on atenolol therapy. Administering the medication as prescribed will help maintain the client's cardiac stability and prevent further complications. Option A (Hold the medication) is incorrect because the client's pulse rate of 65 bpm is not indicative of bradycardia in this context. Holding the medication without a valid reason could lead to inadequate treatment and potential complications. Option B (Call the healthcare provider) is unnecessary at this point since the client's pulse rate is within the expected range for someone on atenolol therapy after a myocardial infarction. There is no immediate need to contact the healthcare provider based on the information provided. Option D (Check the blood pressure) is not the priority in this situation. While monitoring blood pressure is important, the client's pulse rate is the primary parameter to assess when administering atenolol, as it directly reflects the drug's effect on heart rate. Educationally, this scenario highlights the importance of understanding the rationale behind medication administration in specific clinical contexts. It emphasizes the need for nurses to critically think, apply pharmacological knowledge, and make evidence-based decisions to provide safe and effective care to clients, especially in post-myocardial infarction settings where medication management plays a crucial role in recovery.
Question 3 of 5
The wife of an older adult man who has had diabetes mellitus for the past 10 years reports to the home health nurse that her husband fell yesterday while taking his daily walk in the neighborhood. He has a bruised hand and a small abrasion on his left knee. The nurse assesses that his neurologic vital signs are stable. To reduce risk for future falls, which assessment is most important for the nurse to obtain?
Correct Answer: B
Rationale: In this scenario, the most important assessment for the nurse to obtain to reduce the risk of future falls for the older adult man with diabetes mellitus is the degree of paresthesia in his feet (Option B). Paresthesia, which refers to abnormal sensations like tingling or numbness, is common in individuals with diabetes and can increase the risk of falls due to decreased sensation and proprioception in the feet. Assessing the current blood sugar level (Option A) is important in managing diabetes, but in this case, the focus is on preventing falls specifically related to neuropathy. Checking the wound healing of the knee abrasion (Option C) is important for overall care but does not directly address fall prevention. A1c glycosylated hemoglobin (Option D) provides information about long-term blood sugar control but does not address the immediate risk of falls due to neuropathy. Educationally, this question highlights the importance of assessing for paresthesia in diabetic patients to prevent falls, a common complication in this population. It emphasizes the need for nurses to prioritize assessments based on the patient's specific condition and risk factors to provide targeted and effective care.
Question 4 of 5
The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?
Correct Answer: C
Rationale: The correct answer is C) contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year. This intervention is the most direct and effective way to ensure that students receive the necessary immunizations in a timely manner. By directly contacting parents, the school nurse can communicate the importance of completing the vaccine series and provide clear instructions for compliance. Option A is incorrect because simply noting in student records does not actively ensure that the second dose is administered. Option B is less effective as sending notices home on the first day of class may lead to delays in compliance. Option D is also incorrect as speaking at a PTA meeting may not reach all parents and may not result in immediate action. In an educational context, this question highlights the role of the school nurse in promoting and maintaining the health of students through effective communication and proactive measures to ensure compliance with immunization requirements. It emphasizes the importance of timely vaccination to prevent the spread of vaccine-preventable diseases in a school setting.
Question 5 of 5
During a home visit, a nurse observes an older client who is attempting to ambulate to the bathroom and notes that the client is unsteady and holds on to the furniture while refusing any assistance. Which action should the nurse implement?
Correct Answer: A
Rationale: In this scenario, the correct action for the nurse to implement is to determine home navigational safety hazards (Option A). This is crucial because the nurse has observed the client being unsteady while ambulating, which indicates potential safety risks within the home environment. By assessing and identifying these hazards, the nurse can create a safer space for the client to move around independently and reduce the risk of falls or accidents. Option B, maintaining the client's privacy while in the bathroom, is not the most appropriate action in this situation as the primary concern is the client's safety while ambulating. While privacy is important, it is secondary to ensuring the client's physical safety. Option C, recommending that the client obtain a walker, and Option D, encouraging the client to obtain a medical alert device, are also not the most immediate actions to take. While both of these interventions may be beneficial for the client in the long run, addressing the home safety hazards is the most critical step to prevent immediate harm or injury to the client. In the context of community health nursing, it is essential for nurses to prioritize client safety and well-being during home visits. By addressing environmental safety concerns, nurses can empower clients to maintain their independence and quality of life while minimizing the risk of accidents or injuries in their home environment.